PATIENT 101

How to Have a Successful Surgery

By Richard Santoro and Tim BransonThe 700 Club

Dr. Michael Roizen of the Cleveland Clinic is about to share some of the best ways to deal with your fears and help ensure a successful surgery.

“One of my friends was having a very delicate operation on his retina,” says Dr. Roizen. “And he said, ‘It’s free here,' where he was. ‘If I go to where you refer me, I’ve got to pay the 20 percent co-pay.’ I said, ‘Look, you’re not that poor, and retirement is a lot better if you can see.’”

When it comes to surgery, Dr. Roizen says, “there are a lot of things you can do to make it safer for you.”

The first thing he says is to carefully select your surgeon.

“You don’t really care about a long-term relationship with most surgeons. What you really want is a specialist. You want someone who just does mitral valve repairs. You don’t want a cardiothoracic surgeon. A cardiothoracic surgeon may have done five mitral valve repairs in his life or in the last year. You want someone who does it day in and day out -- and that’s all he does. You’ve got a mitral valve that needs fixing, you want the best!”

So, how does a smart patient find a good surgeon with highly specialized skills? Dr. Roizen suggests you find a doctor in the same field of medicine and ask whom they would go to for the specialized care that you need.

Then ask the specialist how many times he or she has performed that particular service. Call the hospital operating room during their down time – usually between 3 and 5 pm – and ask an anesthesiologist for a recommendation.

Dr. Roizen, who is an anesthesiologist, says, “We’re connoisseurs of surgeons. We know who does mitral valves or who does left knees. If you can’t get to them, ask the head OR (Operating Room) nurse or the OR nurse who specializes in orthopaedic surgery, because they watch these people day in and day out.”

However, Dr. Roizen stresses the importance of getting a second opinion before you elect to have surgery.

“Thirty percent of the time a second opinion will change a major diagnosis. One out of three times you get a second opinion, it’s going to change either the therapy or an operation. Yet only 20 percent of people ever get second opinions for major things. Most insurance companies will pay for second opinions ‘cause it saves them money if you only need a pill, not major surgery.”

Three things can happen with a second opinion. It can confirm the original diagnosis and give you the confidence to proceed; contradict the diagnosis and encourage you to seek a third opinion; or it can modify the original diagnosis or treatment plan.

“I won’t even get a blood pressure pill without getting a second opinion. You’re going to be living with that blood pressure pill for 20 or 30 or 40 years. You might as well make sure it’s the right one for you,” Dr. Roizen suggests.

Dr. Roizen took The 700 Club on a tour of the Cleveland Clinic operating suite to share more tips on how to increase your chance of a successful surgery.

He continues, “Only about 20 percent of people -- even when we ask about it -- tell of their alternative medications. Alternative medications interact with anesthetics. So, if you’re on a ‘G’ (glucosamine, ginko, ginger, all of the G’s), you’d better tell your doc, because those interfere or act to antagonize some of the medications we give.”

What about people who are taking illegal drugs? Dr. Roizen says, “This is a confidential period of time, and you really should tell your doctor. For example, if you are taking cocaine, it will make the amount of anesthesia I have to give you greater. So if you’re taking cocaine and you don’t tell me, I may give you an inadequate amount of anesthesia. On the other hand, other drugs may have different effects. But you want to let your anesthesiologist know.”

In preparing for surgery, Dr. Roizen suggests patients remove all make-up ("It hinders us, because we want to see normal color") and even jewelry. “There are only three things that can happen to them," Dr. Roizen explains. "They get lost, they get stuck inside you, or they carry bacteria and the bacteria infect you.”

Other than follow the doctor’s orders, what can you do to help your recovery after an operation?

“Walk,” Dr. Roizen suggests. “As soon as you can, get mobile. Instead of having the risk of clots, by walking around you decrease that. You decrease inflammation in your body just by walking around. You make your lungs move bigger and more extensively. You decrease your chance of pneumonia and lung infections, and you improve your immune function so your whole body works better.”

Surgery can be kind of scary for a lot of people. There are ways to ease your anxieties.

Dr, Roizen says, “Remember, the vast majority of patients -- there’s something like 30 million of them -- undergo operations every year in the United States and do quite well. So, one, you’ve got good odds. Talk to your anesthesiologist and surgeons. Have confidence in them. If you picked the right surgeon, the right hospital, and you’ve done the right things in getting prepared yourself, you have a great chance of doing very well.”